Patient discussions
Advise patients and families to remember that having had KD is part of the patient's permanent medical history. Inform them that children who have coronary artery aneurysms need continued medical testing (including screening for lipid disorders from 2 years of age and for the development of hypertension), long-term medications, and, sometimes, precautions with physical activity (if on anticoagulation therapy or with myocardial ischemia or arrhythmias).[75] Patients and families may benefit from psychological support, especially during teenage and young adult life.[12]
Advise parents that children with large or giant aneurysms, or myocardial ischemia, will need long-term follow-up in the pediatric cardiology clinic.
Arrange and discuss proper transition from the pediatric cardiology clinic to a specialist adult Kawasaki disease cardiology clinic, as ongoing problems may differ from adult ischemic heart disease. During the transition period, joint pediatric and adult care is recommended.[12]
Patients who have current or previous coronary aneurysms (American Heart Association level 3 or above) are advised to have a person-specific protocol in case of a suspected cardiac emergency. Copies of this document should be held by the patient, parents, school or care-providers, and general physician, as well as local specialist cardiac centers and emergency services. It should include a copy of the patient's medical history with instructions to emergency services on which specialist center to transport the patient to, as well as their most recent ECG and coronary imaging and instructions on how to contact their specialist team for advice, both in and out of clinic hours.[12]
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